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Cited by 108Total Knee Arthroplasty OutcomesHealth Systems, Economic Evaluations, Quality of LifeOrthopaedic implants and arthroplasty

Joint Recovery Programme Versus Usual Care: An Economic Evaluation of a Clinical Pathway for Joint Replacement Surgery

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Brunenberg, Daniëlle E., van Steyn, Mike J., Sluimer, Judith C., Bekebrede, Linda L., Bulstra, Sjoerd K., Joore, Manuela A.·2005·Medical Care
DOI 10.1097/01.mlr.0000178266.75744.35
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Abstract

OBJECTIVE: The objective of the present study was to determine the incremental cost-effectiveness of a clinical pathway for patients undergoing joint replacement, the Joint Recovery Programme (JRP), as compared with usual care. The existing care process was revised to contain costs and shorten waiting lists by facilitating patient flows and improve healthcare efficiency. METHODS: The study design was a before-after trial. In total, 160 patients undergoing total hip and total knee replacement, aged 28 to 87 years (mean age, 64.4 years), were treated either according to the Joint Recovery Programme (a standardized care process with patient education and rehabilitation in groups) or usual care. Both groups were followed for 1 year. Costs were studied from a societal perspective. Outcomes included functional level (Harris Hip score and American Knee Society score) and generic quality of life (EuroQol). RESULTS: The results indicate that the Joint Recovery Programme resulted in a significant cost saving when compared with usual care mainly as a result of a considerable (>50%) reduction in length of hospital stay. The average cost saving per patient amounted to $1261 in the total hip replacement group and $3336 in the total knee replacement group. At the same time, both functional level and quality of life were higher in the JRP group. CONCLUSIONS: Clinical pathway dominates usual care and is a highly cost-effective approach to contain costs related to joint replacement surgery without adverse consequences for patients.

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Authors
Brunenberg, D. E., van Steyn, M. J., Sluimer, J. C., Bekebrede, L. L., Bulstra, S. K., & Joore, M. A.
Affiliations
  • Maastricht University Medical Centre (NL)
  • University Medical Center Groningen (NL)
Corresponding author
  • Brunenberg, Daniëlle E.
  • Joore, Manuela A.
ORCID
Venue
Medical Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2005-10
Volume
43
Issue
10
Pages
1018-1026
ISSN
0025-7079 (ISSN-L)
DOI
10.1097/01.mlr.0000178266.75744.35
OpenAlex
W2124196953
Cited by
108
References
38
Citations by year
2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 4 · 2017: 8 · 2016: 5 · 2015: 4 · 2014: 6 · 2013: 7 · 2012: 5
FWCI
7.26
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Medical Care (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Surgery › Total Knee Arthroplasty Outcomes
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Medicine › Surgery › Orthopaedic implants and arthroplasty
Keywords
care pathways, total hip arthroplasty, total knee arthroplasty, joint replacement, cost-effectiveness, length of hospital stay, patient education, group rehabilitation, functional outcome, quality of life, waiting lists, patient flow
MeSH terms
Adult, Aged, Analysis of Variance, Cost-Benefit Analysis, Female, Humans, Length of Stay, Male, Middle Aged, Netherlands, Quality of Life, Program Evaluation, Health Care Costs, Quality-Adjusted Life Years, Critical Pathways, Arthroplasty, Replacement, Hip, Arthroplasty, Replacement, Knee

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